COVID impact on public health programs, Provident MRI scanner, Nursing shortage and agency staffing public comment
Good morning, Chicago! I’m live tweeting the Cook County Health and Hospitals Board of Directors meeting this morning for @CHIdocumenters
Should be starting up any moment! ⬇️🧵
09:03 AM Jan 28, 2022 CST
If you’d like to watch, access the stream on the @CookCtyHealth Facebook page: https://www.facebook.com/Cookcountyhhs/videos/1054391265137994
Right now they’re going through a list of individuals “who have been supportive in opening up our community vaccination sites” and thanking them https://t.co/EXNrHqK7NS
“It would’ve cost us $10 million to get the advertising we’d got,” Caryn Stancik said (had they paid for it) concluding the employee recognition portion of this meeting. https://t.co/jqWhEyjc5j
We’re now moving into the public comment portion, of which the Chair said there’s 9 submissions.
Were having some difficulty with tech — there’s an echo issue with the audio.
“COVID-19 has forever changed the landscape of healthcare and nursing,” Barb OBrien said, a RN with CCH. “Cook County Health and Hospital systems is hemorrhaging.”
see Barbs comment on the live chat: “Wonderful — way to go! Would love to be a part of this!” https://t.co/E9QnKgB6mW
“On the night sift, nine nurses have left since November,” another public commenter said. She’s worried that the replacements they’re bringing in don’t have the necessary skills and are making errors — describing many situations in which patients have been incorrectly cared for.
“At this point, flexing nurses would mean leaving the entire ICU onto agency nurses,” she said. The agency nurses, who are making the mistakes, are making “three to four times” the regular nurses.
“Our hospital did well with our last Jayco visit. I believe our agency went from an F in 2020 to a C in 2021,” she said.
Another public comment calls their recent work experience as a nurse “nothing short of a nightmare.” They said they’ve been told if they get COVID, they’re required to use their time off. “I may not be able to provide food or medicine for my family.”
“This failure to meet our basic needs underscores how devalued nurses are right now,” they said. “The highest levels of nursing administration are being pulled to the floor.”
Angela Walker is the next speaker, she’s been a nurse for 23 years.
She asks that nurses are given proper incentives and respect so they can continue their job without relying on agency nurses.
Another public commenter said “I’ve already used up my COVID hours since I got sick at the beginning of 2020,” they said, calling it “unethical” to assume nurses would only get sick once throughout the pandemic.
“Please support nurses who are putting their own health and potentially their family’s health at risk to care for your loved ones,” they said.
The next public commenter says “exposing to the virus is not our choice.”
Rashawn Bolden says “the system is already strained and now with omicron there are talks of deploying nurses to other parts of the CCH,” they said. Last time this happened, Bolden was pulled into the jail where nurses felt unprepared and unsafe.
Tasha Moseley Brown is now speaking: “I’ve recently entered into my 20th year of nursing,” they said. “This has, sadly, been the worst of my nursing years.”
Brown says they’re having to fight for things that’ve already been negotiated into their contracts. “We’re human beings that have family,” they said.
The next item on the agenda is a review of previous minutes — no corrections are made and they’ll be voted on later.
“Sometimes it’s very difficult to navigate the Cook County Hospitals system,” Amos said, explaining the “SOP development and process workflows” proposed quick win.
“The time period from offer letter to onboarding is high. I hope these efforts will also improve this process,” Barb OBrien said in the stream chat.
Director Herrington is asking where we are on the timeline — “We have already finalized the contract, the kickoff meeting is scheduled for next Tuesday,” Amos said. “We think we have a good template to get this kicked off.”
There are 5 permanent recruiters at this point. They lost some contract support who left them for permanent jobs — totaling 5 perm + 2 FTE’s … “we hope to double the size of our recruitment workforce next month,” Amos said, calling their effort “soft” this month. https://t.co/lx3UNovAIr
They post multiple positions behind one job listing, for clarity. So, online it could look like there is only one posting for a specific position, but it could represent 25 openings (for example). https://t.co/YLxGxY8ZX1
Director Kim is asking how we can contextualize this data, given COVID.
“The recruiting resources in the market are thin,” Amos said. “Most are working virtually.” … “We’re attempting to be more strategic with the processes.”
“We need to get to the finish line of sealing those offers,” Amos said. “Driving change is going to take the collaboration of all.”
Director Story has a few questions: On the vacancy count- does that include the approved positions for this fiscal year?
This slide does not represent all of FY22, “that number is tipping 2,000 vacancies,” Amos said.
Industry standard is “30-50 vacancies” per recruiter Amos said is the ratio that should be the standard. They’re trying to drive change by doubling, “and hopefully, tripling, the size of the team.”
“In addition to the project management support, we have an RPO that’s also going to bring additional resources,” Amos said.
Amos said they hope to have the support of Cook County Bureau of Technology in these efforts https://t.co/6DPtA96CV1
Director Prendergast is wondering if the future events are planned as virtual or a mixture of in person and online — “we’re meeting daily on this, we will determine if we can come onsite for some of these fairs,” Amos said.
“We want to eradicate the contracted agency support,” Amos said, but it’s their short term plan until they can get permanent hires. https://t.co/C9ZBPitNdZ
Director Herrington: We’ve been asking people to come and save lives, but some people are saying coming to the hospital is a risk to their life.
“If we do nothing — we will fail,” Amos said, acknowledging the challenges in front of them.
That concludes Amos’ presentation. “Recognizing human capital issues is really the topic we’re talking about now,” Lyndon Taylor said.
Mike Koetting is reviewing the previous meetings and three annual reports in the packet that the board has.
“Actual recoveries from fraud, waste and abuse” are lagging, he said, and they’ve stepped up the proactive side of this with computer programs.
They have a new Chief Compliance Officer, “a big part of last year was spent trying to backfill” not having that position filled, Koetting said.
“The scale of the research enterprise,” was “eyebrow raising,” to him, Koetting said.
They’re going to review an internal audit in closed session, nothing will need to be approved in closed session.
Director Munar is reviewing the managed care committee minutes: they’re meeting with the secretary of the board for a future presentation to this body to share a presentation on approaches from their past meeting.
With no further questions — the board is moving forward to a combined motion to approve a series of meeting minutes — combined motion is moved and seconded
Roll call is now being conducted on the motion — motion passes.
They suspended regular inspections and instead began responding to COVID-related complaints. Also provided either phone or in-person guidance on how to promote safety https://t.co/OJFYVIELdk
They began routine inspections again last year, but they’re focused now at COVID and infectious disease safety issues instead of just food-born illnesses
Plans in need of review doubled from 2019 to 2020, many pools were operating despite closure mandates. https://t.co/MQuqE6wBmy
Director Harrington asks if this is residential and public — “yes, municipal-operated pools, private fitness center pools as well as private residential pools,” Reuben said.
They’re were delays in starting these reviews — IDPH also had delays in referring requests to them about safe drinking water in well systems, which then translated to delays in notifying residents https://t.co/737gH28RMj
The plan for eliminating lead exposure; “Basically means repairing doors and windows, which is usually the main issue,” Reuben said. https://t.co/j9wr8r5ICY
“We’ve been able to go into the homes even though our nurses have not,” Reuben said. “There’s a radon testing program and energy efficient referrals so that all homes can get tested.” https://t.co/ULehddBF86
In July, LRA’s were able to go back into houses to inspect (though nurses still couldn’t). https://t.co/G5C4WcOq4q
The COVID worker protection program, they received ARPA funding recently that’ll help fund this program, Reuben said. https://t.co/pD9OjVbDBD
“This doesn’t mean our inspectors will become OSHA inspectors,” Reuben said, but they’re there to help with ensuring worker safety.
Guggenheim is asking about what happens to people who are above a certain income level… can we enforce the lead inspections? how does it happen? — Amos: yes, we can enforce that, and “we take them to court if they don’t do it.” Owner of the unit is responsible, not the renter.
STI field work had to be done from a desk, “we need to go back to focusing on other chronic conditions,” Reuben said. https://t.co/v281b99Un0
“We’ve amazingly maintained a stable workforce,” Reuben said, specifically referring to this department. Now maybe able to hire 2-3 extra sanitarians, something that will help them going forward.
“We have a dedicated, superb epidemiology unit,” Reuben said. “We have several vacancies in the organization where you don’t see a face.” https://t.co/VILAAsJddk
They’ve dealt with population estimates, looking at things on a municipal level and putting these index’s into a dataset to be interpreted together https://t.co/5j6aH9ECkR
That concludes Dr Reubens presentation… there are no questions and we’re about to move onto CEO Rocha’s message to the board.
Director Kenny is asking about whether it’s possible to get the vax rate higher than 60% … “I understand we can’t and shouldn’t line people up and do it regardless of their feeling, but I wonder if we can’t get it up a little.”
Rocha — the population is actually doing better than the national average in terms of receiving the first shot of the vax, the second is harder because people might not stay long enough to get it.
Now moving to the CCDPH presentation by Rocha - 231 kits of Naxpolone have been distributed to community partners by end of Dec 2021, 739 to law enforcement agencies. https://t.co/CGieeTazy7
The contract with the state had a renewal option, which the state chose.
Story: The installation of the MRI unit at Provident is historical, right?
“It was perceived that we’d never be able to have that at the Provident building because of its age,” Rocha said, a move that dramatically increases the capacity of what the hospital can do.
Now onto a quick ARPA review: Cook County received a billion dollars — it’ll be spent between now and FY24 https://t.co/sAJuEkQwe4
Director Kenny: Does this include Chicago? Or just suburban CC?
Rocha: We target all patients, Chicago did receive some specific funding
There are 7 pillars they focus on, and they’ll be doing a SWOT to assess their current position https://t.co/QgvuUOnEgF
Feedback from stakeholders will come from questionnaires, meetings and other forms as COVID allows https://t.co/aMDNfXpicd
At this point, the board is going into a closed session. There’s no action items, so the meeting will adjourn once closed session ends.
Motion for closed session is moved and seconded, now conducting a roll call.
Motion passes and the board has now moved into closed session at 11:43 am.
That’s all from me today, folks!
Thanks for following along :)
More notes from this meeting will soon be available on the Documenters database: https://chicago.documenters.org/assignments/board-of-directors-3270/